CREDENTIALING

CCMSO Credentialing department coordinates the credentialing and re-credentialing verification on all IPA contracted providers. CCMSO Credentialing department, in conjunction with the quality management department, provide information to the Credentialing Committee based on criteria that is accepted and monitored by nationally recognized regulatory agencies and health care quality organizations. CCMSO works with Gemini Diversified Services, a 10-point NCQA accredited Credentialing Verification Organization (CVO) to provide required primary source verifications. The Credentialing Committee is comprised of representatives from all contracted IPAs. It meets monthly and on an ‘as needed’ basis to review the completed files and make appropriate recommendations.